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Pedmont CSB mobile OBAT unit brings addiction treatment to rural Southwest Virginia
Summary
Pedmont Community Services Board described a 34-foot mobile office-based addiction treatment (OBAT) unit that delivers medical, therapy and peer recovery services to rural residents facing transportation, broadband and economic barriers; the unit runs site-based stops, is funded by a State Opioid Response grant, and served about seven to eight people per day on average.
Monica Flora, assistant director of addiction and recovery treatment services at Pedmont Community Services Board, described how her agency’s 34-foot mobile office-based addiction treatment (OBAT) unit is used to reach residents across Martinsville, Henry, Patrick and Franklin counties who lack reliable transportation or local clinical capacity. "We found that access to reliable transportation, cost of fuel transportation housing" was a recurring barrier that led Pedmont to take services on the road, she said.
The mobile unit is a full OBAT clinic on wheels: an entry assessment area staffed by a care coordinator, a therapy suite with a 72-inch bench for counseling and family visits, and an ADA-accessible medical suite with a lift and a rotating medical chair for nursing and prescriber visits. Flora said the unit was built as a removable container on a chassis so the container can be transferred to a replacement chassis if the vehicle is damaged.
Pedmont provides the same interdisciplinary services on the vehicle that it offers in brick-and-mortar clinics: medical evaluations and nursing visits, medication for opioid use disorder prescribed by nurse practitioners, individual therapy, peer recovery support, care coordination and on-site or telehealth interdisciplinary team meetings. "We do not carry any medications or cash money" on the unit, Flora said; staff use an agency vehicle to transport patients to pharmacies when an in-person induction requires a prescription pickup.
The unit’s procurement and funding: Pedmont said it applied for and received State Opioid Response grant funding through the Department of Behavioral Health and Developmental Services and contracted with Farber Specialty Vehicles (Columbus, Ohio) to custom-build the unit; Flora noted long manufacturing and shipping delays between the 2021 order and a June 2023 delivery. She also stated a customization award figure during the presentation ($4,224) and gave recurring operating figures: routine maintenance of about $2,265 in the last year, fuel roughly $30 per month because teams stay at a single site, an insurance budget of about $800 per year, and an approximate annual operating cost of $290,000 (which varies by staffing and configuration).
Operations and outreach are site-driven: Pedmont typically schedules one site per day—food pantries, churches and community centers—operating multiple days a week across counties. Flora said the program often receives referrals from its own offices and from emergency-department bridge-to-treatment work. At high-volume community stops Pedmont staff commonly reach capacity quickly and sometimes rely on peer recovery specialists and care coordinators to pick up individuals who cannot otherwise travel to the site.
Impact and capacity: Flora said the mobile unit averages about seven to eight clients per day when running and that county caseloads vary: roughly 150 active clients in Franklin County, 15 in Patrick County and about 20 in Henry County. She reported improved retention in OBAT services and increased community outreach and naloxone distribution, and said the unit helped reduce stigma by presenting a welcoming, nonclinical appearance.
Lessons learned from implementation included expecting long shipping lead times, training staff specifically for mobile operations (including vehicle maneuver training with local fire/EMS), planning for low or no cell service (adding cellular solutions where possible), arranging site MOUs for facility use and finding creative on-unit storage. During Q&A Flora said Virginia does not require a commercial driver’s license for their configuration but cautioned that interstate travel may trigger CDL requirements under VDOT rules. She also said Pedmont had not experienced zoning issues because the unit is an extension of a registered OBAT office.
The session closed with the Academy host noting the recording and slides would be posted and directing listeners to the Virginia Opioid Abatement Authority website for more information.
